THRIVE Your journey to mental well-being
Understanding
SUBSTANCE USE
Table of contents Substance misuse 3 4
What is substance misuse? Impact of substance use on a healthy life
Alcohol 5 6
Alcohol overview and risks Alcohol withdrawal facts
Opioids 7
Opioids overview
Sedatives 8
Sedatives overview
Stimulants 9
Stimulants overview
Take action 10
Taking action and available resources
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What is substance misuse? Substance misuse occurs when the frequent and repetitive use of substances (alcohol and/or drugs) causes a disruption in activities of daily living, health problems, or an inability to maintain meaningful engagement at work, school or home. This disruption may surface as social impairment, risky behaviors and impaired control.
Opioid overuse is a worldwide epidemic. In the U.S. specifically, opioid overdose deaths have quadrupled since 1999.3 Overdose rates are HIGHEST among those ages 25 to 45.4
The harmful use of alcohol results in
3.3 million
deaths each year.1
United Nations Office on Drugs and Crime Drugabuse.org 3 https://www.cdc.gov/drugoverdose/epidemic/index.html 4 http://www.hazeldenbettyford.org/advocacy/opioid-data
The consequences of substance use and abuse in the U.S. alone cost more than $740 billion annually in healthcare costs and loss of work productivity.
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2
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Impact of substance use on a healthy life DALYs
Years of “healthy” life lost as a result of disability
=
+
Years of life lost as a result of premature death
DALY = Disability Adjusted Life Years One DALY can be thought of as one lost year of “healthy” life. The sum of these DALYs across the population, or the burden of disease, can be thought of as a measurement of the gap between current health status and an ideal health situation where the entire population lives to an advanced age, free of disease and disability.1 10 million years of life lost as a result of disability caused by drug use 18 million years of life lost as a result of premature death caused by drug use
Figure 1:
Drug use
Disability
DALYs attributed to drug use Birth World Health Organization Figure 1: http://www.unodc.org/wdr2017/field/WDR17_Fact_sheet.pdf 1
Premature death Years of life lost
28 million healthy years of life lost as a result of
DRUG USE.
Expected life years 4
Alcohol Acting as a central nervous system depressant, alcohol affects every organ in the body. Alcohol is often used to alleviate feelings of stress and anxiety, however the rebound effects during withdrawal can increase these feelings. Factors that impact the effects of alcohol include: age • sex • race • family • history • health
Alcohol abuse is drinking too much, too often. The pattern can lead to inability to fulfill responsibilities at home, work, and other areas of life and may cause a person to engage in risk taking behavior. Alcohol dependence is the inability to quit drinking alcohol, including an increased tolerance (the need to drink more to get the same impact), potential withdrawal symptoms and loss of control related to drinking.
• • • •
Short-term risks include: • Injuries • Alcohol poisoning • Risky behavior Long-term effects include: • Mental health problems including depression and anxiety • Heart disease • Stroke • Liver disease • Increased risk for cancer • Memory impairment • Dementia
Alcohol can impact your sleep.
Interrupts the chemicals that initiate REM sleep Disrupts natural circadian rhythm Exacerbates breathing problems Nighttime waking to use the restroom To learn more about developing healthy sleeping habits, click here.
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Alcohol withdrawal facts Detoxing correctly is important, and going cold turkey is not always the safest way to do it The more dependent a person is on alcohol, the more severe the symptoms are likely to be Alcohol withdrawal can be very serious. Some symptoms include: 6-12 hours • Anxiety • Insomnia • Nausea • Abdominal pain • Hand tremors
12-48 hours • High blood pressure • Increased body temperature • Confusion • Increased heart rate • Hallucinations (30% of people) • Cardiac arrest is a concern
48-72+ hours • Shakes and seizures • Hallucinations • Delirium tremens (Psychotic condition with confusion, shaking, and severe hallucinations)
Most symptoms will decrease within 5-7 days. Symptoms can go on in less severe forms for weeks. Alcohol withdrawal can take up to 72 hours with the most serious symptoms peaking around 12-48 hours. Severity of symptoms may vary. We recommend consulting with a healthcare provider for your health and safety.
Alcohol withdrawal is specific to each individual and influenced by several factors, including length of time drinking, amount consumed, medical history, and history of addiction
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Opioids Although opioids are typically prescribed for pain, they are frequently used to self-medicate for symptoms of anxiety, which is considered using prescriptions “non-medically,” or not as prescribed. Even when used properly, many people find the effect so pleasing that it becomes easier to take the substance recreationally.
What do opioids do? • Lowers the number of pain signals sent to your brain • Slows breathing • Reduces immune response
Indicators of opioid abuse: • Developing an increased tolerance • Having multiple prescriptions from different providers • Refilling prescriptions early
TYPES OF OPIOIDS Prescription opioids: • Fentanyl (Duragesic) • Oxycodone (Oxycontin, OxyIR) • Codeine (Tylenol 3) • Hydrocodone (Vicodin, Norco)
• Morphine (Kadian) • Meperidine (Demerol) • Hydromorphone (Dilaudid) *If you are misusing a prescription, it is considered an illicit use of a medication.
Illicit opioids: • Heroin (use often begins after prescription painkiller use) • Cocaine
There is always a risk of addiction when taking an opioid. If you are prescribed an opioid for pain related to an injury or illness, communicate with your provider about any concerns, take the medication as prescribed and be aware of how the medication affects you over time. Opiate withdrawal can take up to 72 hours. Severity of symptoms may vary. We recommend consulting with a healthcare provider for your health and safety.
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Sedatives Sedatives are prescribed to generate calm and induce sleep. However, they are often misused and taken to reduce anxiety, stress, tension and irritability.
Withdrawal symptoms often include (but are not limited to):
• Feelings of anxiety or depression
Long-term use and abuse has been linked to:
• Racing thoughts
• Increased symptoms of depressed mood • Impaired perception of space and time • Slowed thinking and slurred speech
• Hallucinations • Seizures Withdrawal can be quite dangerous if attempted without medical supervision.
Prescription sedatives: • • • •
Xanax Klonopin Valium Medical Marijuana
• Haldol • Ativan • Sleep medications (Ambien, Halcion, Lunesta)
Next Stop: Sleep Toolkit
Non-prescription sedatives: • • • •
Benadryl • Zzzquil • Tylenol/Advil PM Dramamine Recreational Marijuana • Unisom Nyquil
Non-prescription sedatives have potential for misuse when used for extended time or when you do not follow the directions for use. If you have concerns about how to use these medication, contact your primary care provider.
https://sleepfoundation.org/sleep-topics/how-alcohol-affects-sleep
RESTORE: Digital Cognitive Behavioral Therapy App 8
Stimulants Stimulants increase your alertness and awareness. They can often be unknowingly abused when people are sleep-deprived or wanting to increase productivity.
Stimulants can:
• Raise blood pressure, heart rate and breathing rate • Lead to irregular heart rate, heart failure, or seizures • Increase hostility, paranoia and psychosis
During the withdrawal from stimulants, many people report feelings of depression (which some report to steadily increase), occasional suicidal ideation, feelings of paranoia, and, in some cases, hallucinations. Withdrawal can be quite dangerous if attempted without medical supervision.
Non-illicit stimulants: • • • •
Adderall Ritalin Caffeine Ephedrine
• Nicotine • Pseudoephedrine • Over the counter stimulants such as No-Doz
Illicit stimulants: • Methamphetamine • Ecstasy
• Cocaine 9
Take action and know your resources Recognize signs and symptoms Are you experiencing these signs and symptoms? • Decreased involvement in extracurricular activities • Loss of interest in work or lack of interest in friends or family • Depression • Preoccupation with substance or inability to control consumption of substances • Erratic or irrational behavior
Feel empowered to get support If you find yourself experiencing any of these symptoms please seek assistance through any of the following avenues: • My Life Resources (EAP) • SHADE: Digital Cognitive Behavioral Therapy app • Primary Care Provider • Associate Relations • Emergency room • Substance abuse recovery facilities • Friends and family
Know your options if you observe substance abuse in others • Express concern for their situation • Direct them to the appropriate resources • Keep their story private and do not share with others • U.S. Associates, please review the Substance Abuse Policy 12 10
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